Medical Director Clinical Advocacy and Support - Telecommute
- Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations.
- Document clinical review findings, actions and outcomes in accordance with policies, and regulatory and accreditation requirements.
- Engage with requesting providers as needed in peer-to-peer discussions.
- Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews.
- Participate in daily clinical rounds as requested.
- Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy.
- Communicate and collaborate with other internal partners.
- Call coverage rotation
- M.D or D.O.
- Board certification approved by the American Board of Medical Specia ...For complete description tap [HERE]
Colorado Residents Only: The salary range for Colorado residents is $254,600 to $295,200 (the range and pay mix of base and bonus is variable based upon experience and metric achievement). Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
Posted June 2, 2021